Ch. 6 Pediatric Success - Cardiac

31.Which plan would be appropriate in helping to control congestive heart failure (CHF) in an infant?

Feeding in semi-Fowler position.

26.The _____________________ serves as the septal opening between the atria of the fetal heart.

Foramen ovale.

23. What associated manifestation might the nurse occasionally find in a child diagnosed with Wilms tumor?

Hypertension.

30. A child diagnosed with congestive heart failure (CHF) is receiving maintenance doses of digoxin and furosemide. She is rubbing her eyes when she is looking at the lights in the room, and her HR is 70 beats per minute. The nurse expects which laboratory finding?

Hypokalemia.

6. Which statement by a parent of an infant with congestive heart failure (CHF) who is being sent home on digoxin indicates the need for further education?

I will mix the digoxin in some formula to make it taste better."

47. The flow of blood through the heart with an atrial septal defect (ASD) is_____________________.

Left to right.

34.Which statement by the mother of a child with rheumatic fever (RF) shows she has good understanding of the care of her child?

"I will give him the aspirin that is ordered for pain and inflammation."

18.During a well-child checkup for an infant with tetralogy of Fallot (TOF), the child develops severe respiratory distress and becomes cyanotic. The nurse's first action should be to:

Hold the child in knee-chest position to decrease venous blood return.

1.What can an electrocardiogram (ECG) detect? Select all that apply.

Ischemia. Injury. Dysrhythmias. Conduction delay.

43. An 18-month-old with a myelomeningocele is undergoing a cardiac catheterization. The mother expresses concern about the use of dye in the procedure. The child does not have any allergies. In addition to the concern for an iodine allergy, what other allergy should the nurse bring to the attention of the catheterization staff?

Latex.

48.Patent ductus arteriosus causes what type of shunt? _____________________.

Left to right

54.Which physiological changes occur as a result of hypoxemia in congestive heart failure (CHF)?

Polycythemia and clubbing.

38. A child has a Glasgow Coma Scale of 3, HR of 88 beats per minute and regular, respiratory rate of 22, BP of 78/52, and blood sugar of 35 mg/dL. The nurse asks the caregiver about accidental ingestion of which drug?

Beta blocker.

4. A 10-year-old child is recovering from a severe sore throat. The parent states that the child complains of chest pain. The nurse observes that the child has swollen joints, nodules on the fingers, and a rash on the chest. The likely cause is _____________________.

Rheumatic fever or RF.

7. Which finding might delay a cardiac catheterization procedure on a

Severe diaper rash.

35. A child has been diagnosed with valvular disease following rheumatic fever (RF). During patient teaching, the nurse discusses the child's long-term prophylactic therapy with antibiotics for dental procedures, surgery, and childbirth. The parents indicate they understand when they say:

She will need to take the antibiotics for the rest of her life.

40.The nurse is caring for an 8-year-old girl whose parents indicate she has developed spastic movements of her extremities and trunk, facial grimace, and speech disturbances. They state it seems worse when she is anxious and does not occur while sleeping. The nurse questions the parents about which recent illness?

Strep throat.

13. While assessing a newborn with respiratory distress, the nurse auscultates a machine-like heart murmur. Other findings are a wide pulse pressure, periods of apnea, increased PaCO2, and decreased PO2. The nurse suspects that the newborn has:

Patent ductus arteriosus (PDA).

10. Indomethacin may be given to close which congenital heart defect (CHD) in newborns? _____________________

Patent ductus arteriosus or PDA

2. A newborn is diagnosed with a congenital heart defect (CHD). The test results reveal that the lumen of the duct between the aorta and pulmonary artery remains open. This defect is known as _____________________.

Patent ductus arteriosus or PDA.

33.A 10-year-old has undergone a cardiac catheterization. At the end of the procedure, the nurse should first assess:

Pulses.

55.Aspirin has been ordered for the child with rheumatic fever (RF) in order to:

Reduce joint inflammation.

3. Tetralogy of Fallot (TOF) involves which defects? Select all that apply.

Ventricular septal defect (VSD). Right ventricular hypertrophy. Pulmonic stenosis (PS). Overriding aorta.

17. Congenital heart defects (CHDs) are classified by which of the following? Select all that apply.

Defects with increased pulmonary blood flow. Defects with decreased pulmonary blood flow. Mixed defects. Obstructive defects.

45. A 3-month-old has been diagnosed with a ventricular septal defect (VSD). The flow of blood through the heart is _____________________.

Left to right.

27. While looking through the chart of an infant with a congenital heart defect (CHD) of decreased pulmonary blood flow, the nurse would expect which laboratory finding?

Polycythemia.

11. For the child with hypoplastic left heart syndrome, which drug may be given to allow the patent ductus arteriosus (PDA) to remain open until surgery? _____________________

Prostaglandin E.

51. Which medication should the nurse give to a child diagnosed with transposition of the great vessels?

Prostaglandin E.

58. During play, a toddler with a history of tetralogy of Fallot (TOF) might assume which position?

Squatting.

21. A toddler who has been hospitalized for vomiting due to gastroenteritis is sleeping and difficult to wake up. Assessment reveals vital signs of a regular HR of 220 beats per minute, respiratory rate of 30 per minute, BP of 84/52, and capillary refill of 3 seconds. Which dysrhythmia does the nurse suspect in this child?

Supraventricular tachycardia.

The most common cardiac dysrhythmia in pediatrics is:

Supraventricular tachycardia.

24.Which drug should not be used to control secondary hypertension in a sexually active adolescent female who uses intermittent birth control?

ACE inhibitors.

32.In which congenital heart defect (CHD) would the nurse need to take upper and lower extremity BPs?

Coarctation of the aorta (COA).

50.The school nurse has been following a child who comes to the office frequently for vague complaints of dizziness and headache. Today, she is brought in after fainting in the cafeteria following a nosebleed. Her BP is 122/85, and her radial pulses are bounding. The nurse suspects she has:

Coarctation of the aorta (COA).

28.The nurse is caring for a 9-month-old who was born with a congenital heart defect (CHD). Assessment reveals a HR of 160, capillary refill of 4 seconds, bilateral crackles, and sweat on the scalp. These are signs of _____________________.

Congestive heart failure or CHF.

52. Which statement by the mother of a child with rheumatic fever (RF) shows she has an understanding of prevention for her other children? (Select all that apply)

Whenever one of them gets a sore throat, I will give that child an antibiotic." f their culture is positive for group A streptococcus, I will give them their antibiotic."

42.A nursing action that promotes ideal nutrition in an infant with congestive heart failure (CHF) is:

1. Feeding formula that is supplemented with additional calories

Hypoxic spells in the infant with a congenital heart defect (CHD) can cause which of the following? Select all that apply.

1. Polycythemia. 2. Blood clots. 3. Cerebrovascular accident. 4. Developmental delays. 6. Brain damage.

A 16-year-old being treated for hypertension has laboratory values of hemoglobin B 16 g/dL, hematocrit level 43%, sodium 139 mEq/L, potassium 4.4 mEq/L, and total cholesterol of 220 mg/dL. Which drug does the nurse suspect the patient takes based on the total cholesterol?

Beta blockers.

20.A 6-month-old who has episodes of cyanosis after crying could have the congenital heart defect (CHD) of decreased pulmonary blood flow called _____________________.

Tetralogy of Fallot or TOF.

12. On examination, a nurse hears a murmur at the left sternal border (LSB) in a child with diarrhea and fever. The parent asks why the pediatrician never said anything about the murmur. The nurse explains:

"The fever increased the intensity of the murmur.".

46.The parents of a 3-month-old ask why their baby will not have an operation to correct a ventricular septal defect (VSD). The nurse's best response is:

"Your baby's defect is small and will likely close on its own by 1 year of age."

8. The nurse is caring for a child who has undergone a cardiac catheterization. During recovery, the nurse notices the dressing is saturated with bright red blood. The nurse:

Apply direct pressure 1 inch above the puncture site.

49.A child has been seen by the school nurse for dizziness since the start of the school term. It happens when standing in line for recess and homeroom. The child now reports that she would rather sit and watch her friends play hopscotch because she cannot count out loud and jump at the same time. When the nurse asks her if her chest ever hurts, she says yes. Based on this history, the nurse suspects that she has:

Aortic stenosis (AS).

5. What should the nurse assess prior to administering digoxin? Select all that apply.

Apical pulse rate.

9. Which interventions decrease cardiac demands in an infant with congestive heart failure (CHF)?

Allow parents to hold and rock their child. Make frequent position changes. Feed the child when sucking the fists. Change bed linens only when necessary. Organize nursing activities.